Descemet’s membrane endothelial keratoplasty (DMEK)

What does it involve?

It is a partial transplantation procedure that enables the selective removal of a diseased endothelial cell layer and its replacement with a healthy one extracted from a donor cornea.

When is it carried out?

Patients with corneal endothelial problems account for about 60% of transplant cases, although very few have benefited from this procedure, because it is not widely used due to its surgical complexity. It enables the corneal endothelium to be replaced by only selecting the inner layers of the cornea without affecting the middle layers.

Prior examination

Comprehensive eye examination.

Before the surgery

The procedure has the same risks as those associated with any kind of surgery. The technique has the important advantage of enabling one donor cornea to be used for two different patients. For example, a patient with damage to only the anterior part of the cornea (keratoconus) can have the epithelium and stroma transplanted, while the endothelium and Descemet’s membrane can be used on a second patient with damage to the innermost layers.

During surgery

Surgery is performed in a controlled manner by means of a microincision that facilitates rapid rehabilitation and prevents fragility in the event of trauma after other types of intervention, counters high astigmatism and precludes the need to use the typical sutures that are characteristic of traditional corneal transplantation (penetrating keratoplasty). As a result, the patient recovers more rapidly, and the level of vision obtained by the receiver (between 90 and 100%) is much higher than can be achieved through traditional transplantation.